DESCRIPTION: A recent General Accounting Office GAO report identified 25 percent of nursing homes as having serious quality problems that can either harm residents or place them at risk of death (GAO, 1999a). In addition, many of these nursing homes were identified as having chronic problems. In separate inspections, approximately 12 months apart. 40 percent of these homes persisted with serious quality problems, most being in the same or similar area of care. Clearly, this is a troubling state of affairs and can only add to the negative image of the nursing home industry. We are in need of research to identify which facilities have persistently poor quality, why this is the case and how improvements can be made. This application examines the first of these research goals. Specifically, we propose to determine which facilities have persistently poor quality. We believe examining persistently poor quality is important. Many research have examined the quality of long-term care others examined specific area of care. The majorities of these studies use cross-sectional data; with the accompanying limitation that the effects identified probably include facilities with sporadic poor or high quality. Consistently poor or high quality is seldom examined, yet this represents a more refined approach to investigating the quality construct.